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Hépato-Gastro & Oncologie Digestive

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Neutropenic enterocolitis Volume 26, issue 7, Septembre 2019

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Authors
1 Institut Curie, Département de radiothérapie, 26, rue d’Ulm. F-75005, Paris
2 Institut Curie, Département d’infectiologie, 26, rue d’Ulm. F-75005, Paris
3 Institut Curie, Département d’imagerie, 26, rue d’Ulm. F-75005, Paris
4 Institut Curie, Département de chirurgie, 26, rue d’Ulm. F-75005, Paris
5 Institut Curie, Département de pathologie, 26, rue d’Ulm. F-75005, Paris
6 Institut Curie, PSL Research University, Département d’oncologie médicale, 26, rue d’Ulm. F-75005, Paris
7 Hôpital Saint-Antoine, Service d’oncologie médicale, F-75012, Paris
* Correspondance

Neutropenic enterocolitis, or typhlitis, is a clinical syndrome that occurs in neutropenic patients. It is characterised by an intestinal mucosal injury that affects mainly the caecum but that often extends to the ileum and the ascending colon. It was initially described in a pediatric population, and in particular in leukemic patients. Several cases of neutropenic enterocolitis have also been reported in immunosuppressed adult patients: patients with hematologic malignancies, patients treated with cytotoxic chemotherapy for solid tumors, organ transplant patients or even AIDS patients.

This clinicopathological entity has been often described but the pathogenesis of neutropenic enterocolitis is complex and not completely understood. The true incidence as well as mortality rate are unknown. However, it is a severe condition that can be life-threatening with mortality rate as high as 50% in some series of severe/complicated cases.

This diagnosis should always be considered in febrile immunosuppressed patients with abdominal pain and diarrhea. It will be confirmed by radiological examinations (bowel wall thickness, local complications).

There are no standardized recommendations for the treatment of patients with neutropenic enterocolitis. A conservative strategy is first preferred, including mainly bowel rest and antibiotics. Surgical management is reserved for complicated and more severe cases.

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